Sweet Sleep

A common question I get in my practice is ‘when will my breastfeeding baby start sleeping through the night?’ I really wish I could predict the future and start answering this question when it’s asked. But the truth is, I don’t know! In fact, no one knows when your baby will start to sleep through the night. But here’s what I DO know. You’re not doing anything wrong! Sleeping through the night (5+hour stretches) is a developmental milestone that every baby meets at different times in their lives. It is normal and expected for babies to wake several times at night. It helps prevent SIDS, helps with baby’s weight gain, mental/emotional health and strengthens the connection between parent and baby. It’s also important to know that there is no evidence to suggest that formula fed babies sleep longer stretches than breastfed babies, contrary to what you may have heard. Moms prolactin levels (milk making hormones) are highest at night and it just so happens that babies tend to be more wakeful at night, especially in the first few weeks after birth. Aren’t babies smart creatures!?

As a mom myself I’ll share my own experience. I have 2 girls, both of them were exclusively breastfed. My first baby slept 5-6 hour stretches of sleep from the day I brought her home from the hospital. When she was 2 months old she was sleeping 8 hours straight. 🙌🏻 Then my second baby was born. She never slept more than a 3 hour stretch of sleep until she was 2 years old (yes, TWO YEARS old). In fact, she’s now 4 years old and still wakes up and comes into our room and night while my oldest daughter snoozes away like a hibernating bear.

Ultimately, it is normal for your baby to wake several times a night. And if you’re waking up with them to nurse you are meeting so many of their needs. You are not creating bad habits. Catch a nap whenever you can, enjoy a cup of coffee and I promise you’ll all be sleeping through the night soon enough.

My Top 10 Favorite products for Breastfeeding Mamas

-My Breastfriend breastfeeding pillow-It’s the best nursing pillow! Firm enough so baby doesn’t sink down into it and it has a buckle to keep baby in place.

-The Haakka- A great tool to have for milk collection on the opposite breast you’re feeding on. Also a great hand pump for on the go or to use when you’re engorged.

-Lansinoh Momma bottle – The best bottle for a smooth transition from breast to bottle. The nipple is shaped perfectly so baby can latch onto it like they would on the breast.

-The Kindest Cup – A great alternative to the Haakka and it allows you to feed baby the collected milk right from the cup.

-The Spectra breast pump- The highest quality non-medical grade double pump on the market.

-Pumpin’ pals flanges-The comfort of these pump flanges are the BEST. Do yourself a favor and get a pair if you pump regularly!

-LadyBug milk collectors- Great for moms who leak milk. Wear them around the house or put one on the opposite breast you’re feeding on. Save the milk collected (change/clean every hour).

-Syringes-Great to have on hand for the colostrum phase. Collect colostrum in them prenatally and freeze or just use after birth to supplement baby with a few ml’s from hand expression.

-Silverette nursing cups- Provides great relief for damaged or painful nipples. Allows cracked nipples to heal and helps prevent infection.

– Coconut Oil- A great every day product to have on hand for dry or cracked nipples. Also good for cradle cap and flaky skin on baby.

Breastmilk Immunoglobulins

As you probably already know, breastmilk is the healthiest food you can provide for your newborn. The nutrient content is one of the many reasons that breastmilk is the perfect food. But did you know your breastmilk also contains live beneficial bacteria, enzymes and immunoglobulins? In this blog, we’ll focus on immunoglobulins.

Immunoglobulins are antibodies found in breastmilk. Breastmilk (unlike formula) is a live substance full of specific cells. The lactating mother transfers her immunities to her baby through breast milk. Remember that nasty virus you had back in ‘02? That cold you fought last month? You might not but your body does and by breastfeeding, you transfer the ‘code’ to fight that virus to your baby. How cool is that!?

IgA is one of the most important immunoglobulins found in breastmilk. IgA coats your baby’s gut protecting it from viruses, bacteria and diseases, making it much more difficult for your baby to experience minor and major illnesses and allergies. IgA can not be made in a factory or a kitchen. It is a live antibody made by the body and it is unable to survive the process it takes to make infant formula. You won’t find true live IgA on the shelf although some great formula marketing tactics might get you to believe otherwise.

By breastfeeding, you’re helping to protect your baby from illness, disease and a compromised immune system. The viruses you already fought in your own body will be recognized and destroyed by your baby’s body if they ever come into contact with those specific pathogens. Isn’t breast milk fascinating?

Planning Date Night with an Exclusively Nursing Baby

Do you need a date day or night away from baby but #1 you aren’t a fan of pumping #2 your baby refuses to take a bottle or #3 you have no milk stored for a bottle? You can still go out on that much needed date! Here’s how to do it.

First, I always have my clients write down nursing sessions, naps and awake times for 1 week before you plan your date. Which feedings were better than others? Which feedings left you feeling like baby sufficiently drained the breasts? What time is baby napping and for how long? After a week or 2, you have probably noticed your newborn has patterns of nursing, sleeping and awake times. Plan your date day/night out after baby’s usual block of an effective nursing session followed by a long stretch of sleep. Does baby cluster feed at night then take a longer stretch of sleep? There’s your window! Or does baby have a good nursing session in the morning then take a long mid-morning nap? There’s your window! Before you go out, nurse baby as long as she wants until she finishes both breasts or falls asleep. Now your breasts are emptied and you likely have a nice 3-ish hour window to slip away until your babe might need another feeding.

Yes, this plan requires some flexibility from caretakers, your partner and you. And you might want to stay close to home the first few times you go out, just in case baby wakes and is hungry. But it can be done and as baby gets older, it becomes easier and baby becomes more predictable.

Still a little uneasy about leaving baby but really need some time away? Let me help! I can review your baby’s daily patterns, learn more about your situation and customize a plan for your weekly date. We can also come up with soothing techniques your caregiver can try to keep baby content until you come home. You deserve this time away!

How do I know When to Switch Breasts?

Years ago the recommendation was to ‘watch the clock’ and switch breasts after 15 minutes of nursing. That is no longer the recommendation and here’s why. Every mom has a different milk storage capacity AND every baby empties the breast at a different rate. One baby may empty her mamas breast in 5 minutes while another baby may need 20 minutes. So how do we know when a breast is empty and it’s time to switch sides?

1. Get in the habit of feeling your breasts before and after a feeding. A full breast will feel harder and an empty breast will feel softer.

2. Listen for swallowing. If baby slows down at the breast and you’re not hearing swallows anymore, give yourself a few breast compressions to fully empty the breast. When baby stops swallowing after breast compressions or comes off the breast after nursing for a while, it’s probably time to switch.

3. When baby comes off the breast, give it a squeeze. If the milk sprays, comes out easily and looks clear-ish/watery, the breast still has milk to offer. Put baby back on this breast to finish. If the milk is just a droplet or two (not spraying) and it looks creamy white, the breast is likely on the emptier side. You can switch breasts at this time.

Keep in mind some babies will only need 1 breast per feeding to be satisfied. It’s better to completely empty one breast than to nurse on both breasts. An emptier breast offers fattier, creamier milk (hind milk) that is helpful for weight gain and reducing gas.

Need some relief on the opposite breast? Hand express until you’re comfortable and offer that breast at baby’s next feeding.

Which Breast Pump should you Choose?

With so many breast pumps on the market, it’s difficult to choose which one to buy. Medical grade pumps, standard double electric pumps and hands-free pumps are the most commonly used. Let’s discuss the different kinds of breast pumps and which ones I recommend, based on different situations.

If you have a baby who was premature and/or a NICU baby and you’re separated for long periods of time, a medical grade pump is probably your best choice. The medical grade pump such as the Medela Symphony is the Ferrari of breast pumps and can help get your milk supply established or help to increase it. The stimulation you get from this type of pump is superior to all the pumps on the market. That’s why it’s a very expensive pump and deemed ‘medical grade’. If you need a medical grade pump, often times insurance will cover the cost to rent it with a prescription from your doctor. Or, you can rent it yourself from a medical supply company.

Standard double electric pumps such as the Spectra, Medela, Motiff, Lansinoh, etc. are the most popular pumps among moms however, they are not all created equal. Most of these pumps are covered by insurance. Be aware, some brands such as the Medela have ‘insurance versions’ of the pump which are much less efficient and sturdy than if you were to buy the same pump in the store. It’s important to know that some double electric pumps just don’t have the ability to stimulate a letdown as well as others. I always recommend the Spectra. I’ve used the Spectra myself (after trying other brands) and I’ve had countless clients who have also used it. The Spectra is far better than any other standard double electric pump on the market right now. It’s quiet, gentle, it has multiple settings, and it tends to be the best at mimicking how a baby suckles and removes milk. I’m not sponsored by Spectra, I’m just sharing my personal and professional opinion. If your insurance covers a Spectra, get this brand. The Spectra insurance version is the same as store bought. The Medela is a very popular pump. I’m not quick to recommend the Medela because it’s loud, it can be rough on the nipples, the insurance version is not as efficient as the store bought one and the motor tends to burn out quicker than others. Don’t get me wrong, I love Medela products and use them often but I’m not a huge fan of their breast pump. I do however, know many moms who use the Medela with no issues and love it.

The other types of pumps on the market that are quickly gaining popularity are the hands free pumps such as the Freemie or the Willow. I love that these pumps can be worn relatively discreetly and they allow a mom to be completely hands free and mobile. I recommend these pumps for second time mamas who only occasionally pump or need to stimulate their breasts a little more after nursing their baby. There’s nothing better than being able to pump milk while chasing around a toddler. However, for some moms, the hands free pumps are not good at increasing or even maintaining milk supply. They don’t have the ‘baby power’ to replace nursing sessions on a regular basis. So if you’re a mom with a history of low milk supply, if you’re going back to work full time or you need to exclusively pump, the hands free pumps are not ideal. Another downside to the hands free pumps are the cost! They are very expensive and it’s not recommended to buy them used because of possible contamination. Not to mention all of the parts and assembling required to use the hands free pump.

If you plan to pump whether it’s occasional or more regularly, ask an LC to help you choose which pump would be best for you and your situation. If we know more about your history and your pumping plans, we can help you choose the best breast pump for you.

A Good Latch

A good latch is everything! Here are a few great things I notice about the way this baby is nursing. Take a look at how wide this baby’s mouth is open. Baby should open wide while latching, similar to the gape of a yawn. This will ensure the baby gets enough of the breast tissue in her mouth, far back to the soft palate where it needs to be. This enables optimal milk transfer. Notice how close the nose and chin are to the breast. Pull your baby in close to you while feeding. This ‘hug’ will help baby maintain that deep latch while nursing. The baby’s body in this pic is in alignment, ear/shoulder/hip, all aligned while facing tummy to tummy with mom. This is important for baby’s comfort and ease of swallowing at the breast. The baby has her hand on mom’s breast. This allows her to be snuggled in close, tummy to tummy without hands or arms in the way. Sometimes you will notice your baby will massage your breast with their hand. This is how they try to initiate your milk to letdown. Be sure to practice a good latch each nursing session to optimize milk transfer and keep your nipples safe from soreness or damage. Can’t get a good latch? Make an appointment with an LC sooner than later. You will be happy you did.

Managing Nighttime Nursing

Exhausted new mamas… I see you. Your newborn baby is waking up every two hours at night to nurse. Your partner wants to help but you haven’t introduced the breast pump and bottle into your routine yet. Your baby’s only food source is you! One of the most common questions I get is ‘How on earth can I get enough sleep at night!?’ Here are my top 5 strategies for managing night time sleep when you’re a breastfeeding mom. There are many more but the following 5 are the most successful tips I’ve known to work for my family and my clients.

1. Don’t let your baby go more than 2 hours during the day without nursing. The more calories they consume in the daytime, the less they will require at night. Be sure to nurse baby right before and right after daytime naps to be sure you stick with this frequent nursing routine.

2. When you’re ready to put baby down for the night, make sure the room is set up for baby’s comfort. This includes white noise, the perfect temperature (68-72 degrees), good airflow (light fan or air purifier), a dark or very dim lit room, and mama or something with her scent nearby.

3. Try placing a mattress on the floor for baby to sleep on, next to the bed you sleep on. When baby wakes at night, you can nurse him/her in your bed or their bed in the side lying position. This should allow minimal waking while both your needs are met (nursing, sleeping).

4. As stated above, nurse baby frequently throughout the day (every 2 hours) and make sure you get in a good nursing session right before bed. When baby wakes for the first nighttime feeding, have your partner bring the baby to you in bed and nurse in the side lying position. Your partner can also be in charge of other needs before after the feeding. Diaper change, rocking, burping, etc. while you continue to stay in a restful state.

5. Follow the ‘safe sleep 7’ and let your baby sleep in your bed. Your baby will surely wake less with you next to them and when they do wake, you can nurse and both go back to sleep without getting up. You’re not creating bad habits or spoiling your baby. You’re meeting both of your needs and surviving the night in the easiest way possible.

It’s important to know that sleeping through the night is a milestone that every baby whether they’re breastfed formula fed, will reach at their own time. Embrace the chaos (and the coffee) and hang in there.

Back to Work for the Breastfeeding Mom

Breastfeeding is finally becoming easier, you’re in a manageable routine, your baby is finally falling into a more predictable feeding pattern and now you have to prepare to go back to work. Sigh. The thought of leaving your baby can cause a lot stress, especially when it’s time to begin preparing for your absence. How and when do you start building a breastmilk stash for baby before you start working? How do you introduce a bottle to a breastfed baby? How do you determine how much milk your baby will need when you’re at work? What should your pump schedule look like when you’re away from your baby? How should you store your milk? Will your baby be willing to take a bottle while you’re gone and breastfeed when you’re together? These are some of the common key questions I hear from working moms and I’ll answer them for you!

How do you begin building a breast milk stash for your baby before you start working?

Believe it or not, you don’t need a huge stash of breast milk saved up before you start work. You really only need 1 days worth of milk saved for your first day back. When you’re at work, you will pump the milk you need for the next work day and so on. Friday’s pumped milk will become baby’s bottle feedings for Monday. If you nurse your baby right before you leave for work and immediately upon return, you will need to leave baby approximately 1-1.5 oz of breastmilk per hour you are separated. With this in mind, you can calculate how much milk you will need saved before that first day back to work. Start collecting milk a minimum of 2 weeks before you start back to work. You can collect milk by adding in pumping sessions after a few nursing sessions throughout the day, especially in the late evening or early morning when your prolactin is the highest. Some moms can collect the amount of milk they need just by using the Haakka on the opposite breast baby is feeding on. Don’t be discouraged if you’re only getting 1/2oz-2oz of milk per pumping session. This is normal! Keep pumping and collecting and eventually you can accumulate the milk you need for your first day back to work.

How do you introduce a bottle to a breastfed baby?

Ideally you’ve started introducing the bottle to your baby around 4-6 weeks old so it’s not completely foreign to them. If you haven’t, that’s ok, start introducing it now (or at least 2 weeks) before you return to work. Get a slow flow nipple for the bottle you’re using and start trying to feed your baby small amounts with the bottle about 1 hour after a nursing session. Always use the paced feeding method when offering the bottle. If you’re unsure what paced feeding is, check out my past blog or look up paced bottle feeding information from La Leche League or KellyMom.

How do you determine how much milk your baby will need when you’re at work?

Plan to nurse your baby right before you leave for work and as soon as you return from work. That way you won’t have to pump as soon as you get to work and right before you leave work. You will need to leave your baby approximately 1-1.5oz of breastmilk per hour of separation.

What should your pump schedule look like when you’re away from your baby?

Ideally Pumping should mimic your baby’s feeding pattern while you’re at work. Since this is not always an option, you can plan to pump at least every 3 hours for 15-20 minutes while you’re away from your baby. Talk to your boss ahead of time and secure a designated quiet place to pump to save time and added stress.

How should you store your milk?

Refrigerate your expressed milk as soon as possible if you don’t plan to feed it to your baby within 4 hours. If you don’t have a refrigerator at work, use ice packs in a cooler to keep the milk cold until you get home. Once you’re home, refrigerate milk you plan to use within 5 days and freeze milk if you plan to use it after 5 days.

Will your baby be willing to take a bottle while you’re gone and breastfeed when you’re together?

Every baby is different! Some babies will find it hard to toggle back and forth from bottle to breast and some transition perfectly. An important step to take to ensure baby comes back to the breast is to make sure your caregiver uses the paced feeding method when bottle feeding. Nurse your baby just before you leave for work and as soon as you arrive home. Plan for extra skin to skin time when you’re together and nurse whenever your baby wants. You might find baby wants to nurse more at night to make up for the time missed with you during the day. If your baby is having a hard time taking a bottle when you’re at work, check out my blog about bottle refusal.

Going back to work can cause a lot of stress for a breastfeeding mama. Keep in mind that you and your baby will eventually fall into a routine and the transitions from breast to bottle will become easier. If you’re having trouble with anything mentioned in this blog, please reach out to an LC! We can help you make a smooth transition from home to work with a care plan tailored just for you and your baby.

Pacifier for the Breastfed Baby?

There are a lot of opinions about pacifiers for breastfeeding babies and some experts will recommend limiting their use or not introducing them at all. Let’s look at the reasoning behind this recommendation. Pacifiers or ‘dummies’ as they call them in the UK are essentially an artificial nipple made for babies to ‘pacify’ them until their next feeding. When we use a pacifier for our breastfeeding baby, especially in the early weeks, we can miss important feeding cues that our baby uses to let us know they’re ready to nurse. Some of these cues are putting their hand to their mouth, sticking their tongue out, mouthing, etc. and are impossible for a baby to do while sucking on a pacifier. Pacifiers also decrease the amount of time our baby suckles at the breast which can sometimes lead to poor weight gain in baby and/or decreased milk supply for mom. When we allow our baby to nurse and/or suckle at the breast often in the early weeks, they are essentially establishing mothers milk supply. Pacifiers can really limit this special communication between the baby and the breast and because of this, babies who receive pacifiers are more likely to wean from the breast earlier than babies who don’t use one.

Pacifiers certainly do have their place and can be beneficial in certain situations, even for babies who are or will be breastfeeding. Pacifiers can help premature infants practice and strengthen their sucking reflex and can help tube fed babies associate sucking with food when given simultaneously. Pacifiers also may help reduce the risk of SIDS. Although, breastfeeding alone already decreases the risk of SIDS by more than 50% so this benefit is more for bottle fed babies. Pacifiers are great when used to soothe babies during medical procedures or even in less serious situations like riding in the car or passing the time while mom runs an errand.

As an LC, I’m often asked if and when a pacifier can be introduced to a baby. I typically ask moms to try and wait at least 4-6 weeks until their milk supply is established first. It’s also important that the baby’s weight gain has been sufficient before offering a pacifier. Make sure you are offering the breast first and only allowing the baby have the pacifier for short intervals such as on car rides, in a store, or in places when nursing isn’t possible. As a mom, you make the best decisions for you and your unique situation and if that includes using an occasional pacifier for your baby, then so be it! However, if you and your baby have been fine getting along without a pacifier so far, save yourself potential problems down the road and just don’t even offer one.